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Pbm Data Analyst Jobs in California (NOW HIRING)

Analyze and monitor large data sets that are exchanged from SCAN to the PBM using a variety of reporting tools. * Accountable for ensuring eligibility and coordination of benefit files are sent to ...

Director, Channel Management

San Diego, CA · On-site +1

$221K - $287K/yr

Strong understanding of PBM channel economics, including retail, mail, specialty, and alternative pharmacy models. * Analytical mindset with experience translating data into actionable insights.

Strong understanding of PBM channel economics, including retail, mail, specialty, and alternative pharmacy models. * Analytical mindset with experience translating data into actionable insights.

Project Scheduler

Mojave, CA · On-site

$86K - $160K/yr

... data integrity between schedule, budget, and performance metrics. * Maintain and update budget forecasts, cash flow projections, and cost tracking based on PBM guidance. * Perform variance analysis ...

Become a deep domain expert in complex healthcare systems -- EHRs, payer portals, PBM formularies ... Comfort with SQL, basic data analysis, or API concepts. * Experience prototyping or shipping ...

Senior Product Manager

Menlo Park, CA · On-site

$160K - $200K/yr

Become a deep domain expert in complex healthcare systems - EHRs, payer portals, PBM formularies ... Comfort with SQL, basic data analysis, or API concepts. * Experience prototyping or shipping ...

Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by ... user security, and data management) to implement approved ticket requests. * Oversee and ...

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Pbm Data Analyst information

What are the key skills and qualifications needed to thrive as a PBM data analyst, and why are they important?

To thrive as a PBM Data Analyst, you need strong analytical skills, expertise in data management, and a background in pharmacy benefit management or healthcare analytics, often supported by a relevant degree. Proficiency in SQL, data visualization tools (such as Tableau or Power BI), and familiarity with PBM software systems are typically required. Attention to detail, problem-solving ability, and effective communication are essential soft skills for this role. These competencies are critical for accurately interpreting complex pharmacy data, informing business decisions, and ensuring regulatory compliance within the PBM industry.

What are the common challenges faced by PBM data analysts in ensuring data accuracy and compliance?

PBM Data Analysts often encounter challenges related to the integration and validation of large, complex datasets from multiple pharmacy benefit management systems. Ensuring data accuracy requires meticulous attention to detail and frequent cross-checking with regulatory requirements, as errors can impact patient care and contractual compliance. Analysts must also stay updated on evolving healthcare regulations and privacy laws, which adds complexity to their data management responsibilities. Collaboration with IT, compliance, and clinical teams is crucial to overcome these challenges and maintain high data integrity.

What is the difference between Pbm Data Analyst vs Pbm Data Analyst?

AspectPbm Data AnalystPbm Data Analyst
Required CredentialsBachelor's in Data Science, Analytics, or related field; certifications like CAP or Microsoft Certified Data AnalystBachelor's degree in relevant field; certifications such as CAP or Microsoft Certified Data Analyst are common
Work EnvironmentHealthcare or pharmaceutical companies analyzing medication data and patient informationHealthcare or pharmaceutical settings focusing on medication management and data reporting
Employer & Industry UsageUsed by healthcare providers, pharmaceutical companies, and health plansCommonly employed in healthcare organizations, pharmaceutical firms, and health insurance companies

The Pbm Data Analyst primarily focuses on analyzing pharmacy benefit management data to optimize medication costs and patient outcomes. Since both titles are identical, the comparison emphasizes the typical roles, credentials, and work environments associated with Pbm Data Analysts in healthcare and pharmaceutical industries.

What is a PBM data analyst?

A PBM Data Analyst is a professional who analyzes data related to Pharmacy Benefit Managers (PBMs), which are companies that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers. These analysts collect, process, and interpret large sets of pharmacy and claims data to help organizations optimize drug spending, ensure regulatory compliance, and improve patient outcomes. They often use statistical tools and data visualization software to identify trends, support business decisions, and generate reports for stakeholders. Strong analytical skills, attention to detail, and knowledge of healthcare and pharmacy data are essential for this role.
What are popular job titles related to Pbm Data Analyst jobs in California? For Pbm Data Analyst jobs in California, the most frequently searched job titles are:
What cities in California are hiring for Pbm Data Analyst jobs? Cities in California with the most Pbm Data Analyst job openings:
Infographic showing various Pbm Data Analyst job openings in California as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Network & PBM Strategy Vice President

MedImpact Healthcare Systems, Inc.

San Diego, CA • On-site

$208.07 - $395.34/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago


MedImpact Healthcare Systems rating

8.9

Company rating: 8.9 out of 10

Based on 13 frontline employees who took The Breakroom Quiz


Job description

## Vice President, Network & PBM StrategyApplyremote type: Remotelocations: San Diego, CAtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR102599### Exemption Status:United States of America (Exempt)### $208,071 - $301,704 - $395,336“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”This position is not eligible for Sponsorship.MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!# **Job Description****Summary**The Vice President, Network & PBM Strategy is a senior leader responsible for defining and executing enterprise network, payer, contracting, underwriting, and operational strategies across the PBM business. This role establishes vision, sets priorities, designs scalable governance and processes, and allocates resources to achieve financial, operational, and growth objectives aligned with the parent organization’s long term strategy.Partnering closely with the sales and account management, trade relations as well as executive leadership, this position drives enterprise level planning, payer and network strategy, portfolio performance, and market differentiation. The role has direct oversight of large chain pharmacy network contracting, PBM Underwriting and will influence and drive successful client pricing strategy, with accountability for PBM P&L performance, operational excellence, and brand growth across all payer segments.**Essential Duties and Responsibilities** include the following. Other duties may be assigned.### Financial & P&L Leadership* Own departmental Profit & Loss (P&L), including revenue, cost of goods sold (COGS), administrative expense management, and margin optimization.* Develop, manage, and forecast budgets; identify and execute strategies that drive sustainable profitability and scalable growth.* Oversee advanced financial modeling, scenario analysis, and forecasting to support executive decision‐making on client deals.* Ensure pricing, contracting, and underwriting strategies align with financial targets, risk tolerance, and long‐term client value.### Enterprise Network & Payer Strategy* Establish and lead the payer and network contracting vision, strategy, and governance framework across all payer segments, including commercial, Medicare, Medicaid, and specialty markets.* Oversee all network‐related functions, including Pharmacy Network Contracting, Provider Contracting, Account Management, and Provider Data Management.* Design and execute pharmacy and provider network strategies that optimize cost, access, quality, and performance.### Contracting, Negotiation & Partnerships* Provide executive leadership for high‐stakes national and regional payer, PBM, and network negotiations, including complex commercial, Medicare, Medicaid, and specialty agreements.* Lead the negotiation and execution of contracts with major retail, mail‐order, specialty pharmacy networks, and payer partners to ensure competitive pricing, access, and compliance.* Champion innovative contracting approaches, including value‐based, outcomes‐based, and alternative reimbursement models.* Build, maintain, and expand executive‐level relationships with senior payer, PBM, and network leadership to advance long‐term strategic partnerships.### PBM Underwriting & Pricing* Direct PBM underwriting strategy, pricing governance, and financial risk assessment activities.* Ensure underwriting models accurately reflect utilization patterns, rebate economics, network costs, reimbursement methodologies, and administrative expenses.* Balance profitability, competitiveness, transparency, and client savings objectives across new business and renewals.### Strategic Planning & Market Leadership* Partner with peer leaders to lead strategic planning, market analysis, business mapping, budgeting, and goal setting.* Anticipate and respond to regulatory, legislative, and reimbursement trends that materially impact payer economics, access strategies, and compliance obligations.* Identify emerging market opportunities, competitive threats, and evolving payer dynamics within the PBM and broader healthcare ecosystem.* Shape, expand, and commercialize payer‐focused service offerings that differentiate the organization and drive revenue growth.### Operational Leadership & Innovation* Provide executive oversight of day‐to‐day operations across all assigned departments, ensuring consistency, efficiency, and scalability.* Establish performance management, analytics, and reporting standards to ensure payer and network contract compliance, optimization, and transparency.* Champion innovation through process improvement, analytics enhancement, automation, and the development of proprietary tools and capabilities.### Compliance, Governance & Risk Management* Ensure compliance with all applicable federal, state, and industry laws, regulations, and contractual requirements.* Partner with executive leaders across Legal, Finance, Clinical, Operations, and Consulting to ensure alignment, governance discipline, risk mitigation, and contract integrity.### Executive Advisory & Client Engagement* Serve as an executive advisor to clients and internal leaders on payer strategy, network design, reimbursement optimization, and market dynamics.* Support strategic client engagements, executive presentations, and complex payer discussions.* Represent the organization as a senior thought leader with clients, partners, and industry stakeholders.**Supervisory Responsibilities** Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary. **Client Responsibilities**This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.# **Qualifications**To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.# **Education and/or Experience**BA/BS Degree or equivalent; plus 15 years’ related experience; 15 years of SME in respective area(s); and 12 years supervisory experience; Supervisory experience may be substituted with 12 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader at the Vice President level or above that must be completed within 12 months in new position.**Computer Skills*** Advanced skill set in MS Office, Teams, Word, Excel, PowerPoint, Project, and Outlook**Certificates, Licenses, Registrations**None required**Other Skills and Abilities*** Recognized Subject Matter Expert in Pharmacy Network and Payer Contracting within the PBM industry.* Deep expertise in MAC pricing, reimbursement models, payer economics, and network strategy.* Proven success with full P&L accountability, including revenue, COGS, and operating expense control.* Advanced knowledge of PBM underwriting methodologies and financial modeling.* Strong executive presence, negotiation skills, and ability to lead complex multi stakeholder initiatives.* Proficiency in Microsoft Office Suite and data driven decision making tools.**Reasoning Ability** * Ability to define problems, collect data, establish facts, and draw valid conclusions.**Mathematical Skills** * Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.**Language Skills** * Ability to make effective and persuasive speeches and presentations on controversial or complex topics to top management, public groups, and/or boards of directors.**Competencies** To perform the job successfully, an individual should demonstrate the following competencies:* Business Acumen* Directing Others* Organizational Agility* Conflict Management* Drive for Results* Political Savvy* Customer Focus* Innovation Management* Strategic Agility* Decision Quality* Managerial Courage**Physical Demands**The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.**Work Environment**The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).**Work Location**This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.**Working Hours**This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.**Travel**This position requires both domestic and international travel of up to 25% of the time. A valid passport and ability to leave the United States is required# **The Perks:*** Medical / Dental / Vision / Wellness Programs* Paid Time Off / Company Paid Holidays* Incentive Compensation* 401K with Company match* Life and Disability Insurance* Tuition Reimbursement* Employee Referral BonusTo explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careersMedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. #J-18808-Ljbffr

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